PATIENT REGISTRATION FORMS
New Patients: Please print and complete these forms to bring with you to your first evaluation.
(Click on each of the 5 pages below for a complete set of forms.)
1. Patient Questionnaire / Body Diagram
2. Optimal Difficulty Baseline
3. Summary of Notice of Privaty Practices (pg 1)
4. Summary of Notice of Privaty Practices (pg 2)
5. Receipt of Summary Notice of Privacy Practices
Employment Opportunities
ORTHOPAEDIC PHYSICAL THERAPIST
Vermont Sports Medicine Center’s continued growth provides a rare opportunity for a dynamic Orthopaedic Physical Therapist committed to
manual physical therapy to become part of our highly skilled team! Excellent compensation, benefits plan, profit share and
exceptional professional development.Will consider exceptional new graduates. Part time, Full time, Per Diem. Vermont License or Eligible.
Resumes to:
Maureen Gibeault, PT - Clinical Director
Vermont Sports Medicine Center
5 Albert Cree Drive
Rutland, VT 05701
VSMC’s 20TH Annual 5K Run/Walk will be held on Saturday, April 21, 2012!
Vermont Sports Medicine
Center | 5 Albert Cree Drive | Rutland, VT
802.775.1300
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